Community programs help teens resist risky behaviors

NEW YORK (Reuters Health) - Giving communities a menu of proven programs to choose from is an effective way to help reduce risky behaviors among young teens, new research shows.

Communities that Care (CTC) is a "prevention system" consisting of 56 different programs designed to reduce risk factors for problem teen behavior or boost factors that protect against such behavior. Communities first survey adolescents to identify high levels of risk factors-like poor parental supervision or school failure--and low levels of protective factors, such as strong community involvement. They then choose two to five factors to work on, and pick programs that address these concerns.

"You can choose tested and effective prevention programs to address elevated risks in your community," explained Dr. J. David Hawkins of the University of Washington in Seattle.

Hawkins and his colleagues compared 24 small towns in seven different states that had been assigned at random to a control group or to implement CTC. To assess the program's effects, the researchers surveyed 4,407 students every year, from fifth grade to eighth grade.

In the CTC communities, Hawkins and his team found, students were less likely to start drinking, start smoking cigarettes, or start using smokeless tobacco, and they were also less likely to start engaging in delinquent behavior. For example, kids in the control communities were 60% more likely to start drinking between seventh and eighth grade than those in the CTC communities, while they were about twice as likely to start smoking or using smokeless tobacco.

By eighth grade, 21% of students in the control communities had initiated delinquent behavior, compared to 16% of kids in the CTC towns.

Among eighth graders in the CTC communities, the likelihood of binge drinking in the past two weeks, as well as drinking and smokeless tobacco use over the past 30 days, were significantly lower. These young people also engaged in fewer types of delinquent behavior.

The federal government owns the CTC program, Hawkins notes, and all the materials are freely available on the Web. However, he added, communities need training to get the system up and running. Some states are putting training systems in place, Hawkins said, and he said he and his colleagues hope the federal government will help provide more resources to communities interested in setting up such systems.

CTC is "ongoing," Hawkins noted. Every two years, communities conduct surveys to determine if the program has helped to reduce the targeted risk factors or increase protective factors, and can decide to continue the current approach if it's working-or try something else if it's not.

Research over the past 30 years, Hawikins points out, has shown reducing early risky behaviors like delinquency and drinking can reduce a teen's risk of committing more serious crimes as an adult, or developing serious substance abuse problems.

In an editorial accompanying the study, Dr. Francis T. Cullen and Cheryl Lero Jonson of the University of Cincinnati point out that "the vast majority of serious youthful offenders receive no meaningful intervention prior to being arrested and processed in the justice system."

The current findings, they add, show "that CTC is a conduit for organizing and then delivering effective interventions in a scientific, systematic way at the community level."

They conclude: "The expanded use of this approach, especially in at-risk communities, seems worthy of further investigation."